Narcissistic Personality Disorder and Treatment

In the analysis of an individual there are three primary methods employed in order to successfully assess and repair his condition- biological, cognitive, and psychoanalytic theory. In the case of narcissism, only the psychoanalytic approach will suffice to structurally repair rather than suppress manifest symptoms of the unfulfilled self. Narcissists must learn to address the needs of their childhood that have not have been satisfied and acknowledge them as the root of their grandiose actions, a facade for their inner sense of shame and insecurity (Kohut, 1978, p. 423). In the case of Mr. Z, he underwent two analyses with a five-year grace period in between, the first analysis unsuccessful in structurally curing his masochistic propensities as they merely shifted to another facet of his life (Kohut, 1979, p.10). This lack of structural change went unnoticed during the first analysis, and was only revealed through examination of the patient's root of disturbance during the second analysis. The agent that assisted the discovery was the change in approach by the analyst within the realm of psychoanalysis, that is the shift from a focus in analysis based upon classical-dynamic structural terms to that of the psychology of the self in the narrow sense. (Kohut, 1979, p. 26).

Through observation of symptoms and examination of life occurrences, it is clear that Mr. Z exhibits the characteristics of narcissism. He has a mother that relied upon him as her self-object throughout his childhood and into his early adult years. This provided conflict in that Mr. Z needed his mother as his own self-object, and due to her selfish role-reversal, he did not receive the mirroring necessary to develop a healthy, strong self-structure. S...

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...e to work through issues in order to abet the repair of Mr. Z's narcissistic self. The employment of "the psychology of the self" in the second analysis led to a focus upon the importance of the self and to relations with others in the environment (Luti, personal communication). All in all, this allowed Mr. Z to discover the reason for his disturbance and learn to lead a happy and healthy life.

Bibliography

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Kohut, H. (1978). "The Disorders of the Self and Their Treatment". International Journal

of Psychoanalysis, vol. 59, p. 413-425

Kohut, H. (1979). "The Two Analyses of Mr. Z". International Journal of Psychoanalysis,

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McWilliams, Nancy. (1994). Psychoanalytic Diagnosis. New York, Guilford Press,

p. 174